Question

Please answer and give rationale

1. A client has returned to the med-surg unit immediately following a bronchoscopy. Which of the following should the nurse include in the care plan for this client?

a. Provide the client with ice chips for comfort

b. note any cough or sputum changes

c. monitor vital signs every hour for the first 4 hr

d. have the client turn, cough, and deep breathe every hour

2. a nurse is caring for a client who has peptic ulcer disease. Which of the following assessment findings indicates perforation of the peptic ulcer?

a. rigid, board-like abdomen

b. hyperactive bowel sounds

c. dull, aching pain in lower quadrants

d. hypertension

3. A nurse is caring for a client who has a pneumonia. Upon assessment, the nurse observes that the client is unable to expectorate sputum. Which of the following interventions is effective in clearing the client's airway?

a. Limit the client's oral and fluid intake

b. place both hands on the upper rib cage to assist the client to cough

c. maintain the client in Trendelenburg position

d. initiate the use of an incentive spirometer

Answer 1

• 1. (c) Moniter vital signs for every hour for the first 4 hours.
• 2. (c) Dull, aching pain in lower the quadrants.
• 3 (b) Place both hands on the upper rib cage to assist the client to cough.